Metroka Amy E, Papadouka Vikki, Ternier Alexandra, Zucker Jane R
New York City Department of Health and Mental Hygiene, Bureau of Immunization, Citywide Immunization Registry, Long Island City, NY.
New York City Department of Health and Mental Hygiene, Bureau of Immunization, Citywide Immunization Registry, Long Island City, NY; Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Atlanta, GA.
Public Health Rep. 2016 Jul-Aug;131(4):583-7. doi: 10.1177/0033354916662217.
We compared the quality of data reported to New York City's immunization information system, the Citywide Immunization Registry (CIR), through its real-time Health Level 7 (HL7) Web service from electronic health records (EHRs), with data submitted through other methods.
We stratified immunizations administered and reported to the CIR in 2014 for patients aged 0-18 years by reporting method: (1) sending HL7 messages from EHRs through the Web service, (2) manual data entry, and (3) upload of a non-standard flat file from EHRs. We assessed completeness of reporting by measuring the percentage of immunizations reported with lot number, manufacturer, and Vaccines for Children (VFC) program eligibility. We assessed timeliness of reporting by determining the number of days from date of administration to date entered into the CIR.
HL7 reporting accounted for the largest percentage (46.3%) of the 3.8 million immunizations reported in 2014. Of immunizations reported using HL7, 97.9% included the lot number and 92.6% included the manufacturer, compared with 50.4% and 48.0% for manual entry, and 65.9% and 48.8% for non-standard flat file, respectively. VFC eligibility was 96.9% complete when reported by manual data entry, 95.3% complete for HL7 reporting, and 87.2% complete for non-standard flat file reporting. Of the three reporting methods, HL7 was the most timely: 77.6% of immunizations were reported by HL7 in <1 day, compared with 53.6% of immunizations reported through manual data entry and 18.1% of immunizations reported through non-standard flat file.
HL7 reporting from EHRs resulted in more complete and timely data in the CIR compared with other reporting methods. Providing resources to facilitate HL7 reporting from EHRs to immunization information systems to increase data quality should be a priority for public health.
我们将通过电子健康记录（EHR）经实时卫生信息交换标准7（HL7）网络服务报告给纽约市免疫信息系统即全市免疫登记系统（CIR）的数据质量，与通过其他方法提交的数据质量进行了比较。
我们根据报告方法，将2014年为0至18岁患者接种并报告给CIR的疫苗接种情况进行分层：（1）通过网络服务从EHR发送HL7消息；（2）手动数据录入；（3）从EHR上传非标准平面文件。我们通过测量报告的疫苗接种中包含批号、制造商和儿童疫苗计划（VFC）资格的百分比来评估报告的完整性。我们通过确定从接种日期到录入CIR日期的天数来评估报告的及时性。
HL7报告占2014年报告的380万次疫苗接种的最大比例（46.3%）。在使用HL7报告的疫苗接种中，97.9%包含批号，92.6%包含制造商，相比之下，手动录入分别为50.4%和48.0%，非标准平面文件分别为65.9%和48.8%。通过手动数据录入报告时，VFC资格完成率为96.9%，HL7报告为95.3%，非标准平面文件报告为87.2%。在这三种报告方法中，HL7最为及时：77.6%的疫苗接种通过HL7在1天内报告，相比之下，通过手动数据录入报告的疫苗接种为53.6%，通过非标准平面文件报告的疫苗接种为18.1%。
与其他报告方法相比，EHR的HL7报告在CIR中产生的数据更完整、更及时。提供资源以促进从EHR到免疫信息系统的HL7报告，从而提高数据质量，应成为公共卫生的优先事项。
